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General NPI Number Information
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NPI Number | 1902454549
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Entity Type | Organization
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Legal Business Name | CIEC INVESTMENTS LLC
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 8409 SUMMIT AVE
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City | SKIATOOK
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State | OK
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Zip | 74070-5540
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Country | US
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Telephone | 918-808-0583
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Fax | 918-396-2090
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Provider Business Mailing Address
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Address Line | 8409 SUMMIT AVE
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City | SKIATOOK
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State | OK
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Zip | 74070-5540
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Country | US
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Telephone | 918-808-0583
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Fax | 918-396-2090
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Authorized Official
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Title or Position | MANAGER
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Name | MISS C PSH
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Credential | CSFA
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Telephone | 918-808-0583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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